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The heroin withdrawal process is a difficult one.  It is taxing on both the mind and body in a number of ways and presents a significant hurdle to recovery for many addicts.  Personal experience often contributes to this, as many heroin addicts struggle with relapsing.

No matter how a person kicks their heroin addiction, they will inevitably deal with some withdrawal symptoms.  The length and severity of their symptoms depend largely on the level of medical care that a patient is receiving.  Withdrawing from heroin can be a scary process, not in the least because it can lead to some serious health complications.  Understanding more about heroin withdrawal is helpful for a number of reasons. Gaining a greater base of knowledge regarding the symptoms of heroin withdrawal can help addicts enrolling in a drug addiction rehab program get a better sense of what they can expect during their detox.  

For the families and loved ones of addicts, understanding heroin withdrawal and identifying the side effects of heroin abuse can give them insight into what the addict in their life is struggling with.  This article will outline the basics of heroin withdrawal, and delve into some of the physical and emotional symptoms that are commonly experienced during the withdrawal process. We’ll also discuss some of the side effects that can occur during heroin withdrawal, and how the risk of these can be minimized through medical care.

Heroin and the Withdrawal Process

Withdrawal from heroin isn’t like many other drug withdrawals.  Although no withdrawal from drugs or alcohol is easy, heroin addicts experience particularly acute symptoms over a period of time lasting up to 10 days.  Gaining a grasp of the timeline of heroin withdrawal helps families that are asking, “How long does heroin withdrawal last?” Understanding the withdrawal process requires first understanding what heroin is in order to understand why it is so difficult to quit using.  Heroin, or diacetylmorphine, is an opiate six times more powerful than morphine, its closest legal analog.

When heroin is used, it interacts with the brain and central nervous system quickly and powerfully, producing feelings of euphoria.  Heroin produces a high quickly, but the body almost immediately begins to break it down. Within 8-24 hours, the heroin in the body has been almost completely broken down and excreted by the system.  Because of the rapid breakdown and excretion of heroin in the body, users will experience the onset of withdrawal symptoms within a short period of time after their last dose. Typically, this occurs within 6-12 hours after taking heroin.

The quick acting high, powerful effects and short life in our body makes heroin a particularly risky drug for recreational use.  Even recreational use can create a chemical dependency on the user. Heroin’s short stay in the body requires the user to continuously be seeking or taking heroin to maintain their addiction.  If they do not, the early stages of withdrawal symptoms will begin to manifest, quickly becoming more powerful and debilitating.

Common Withdrawal Symptoms

Although every person reacts to heroin withdrawal differently, there are some common symptoms and effects that occur in many people.  Symptoms of heroin withdrawal can be broken down into two broad categories; physiological, and emotional. Both the physical and emotional effects of heroin withdrawal present their own unique challenges and hurdles to recovering addicts.  

Many addicts in recovery struggle with a specific aspect of their withdrawal more than others, whether it be increased anxiety or acute insomnia.  Because each person experiences a heroin withdrawal in a way that is unique to them, the following information is neither exhaustive nor complete. Rather, this list should serve as an outline of the most common symptoms generally experienced by the majority of recovering addicts.

Physical Withdrawal Symptoms

The physical symptoms of heroin withdrawal are most commonly described as “flu-like,” meaning heroin withdrawal symptoms are most closely relatable to the common flu.  However, this does little to capture the true nature of heroin withdrawal. While many of the symptoms can fall under the “flu-like” umbrella, in most cases the physical effects of heroin withdrawal are far more acute and protracted than the common flu.  The discomfort, and sometimes agony, of the physical withdrawal symptoms, are exacerbated by the emotional toll that withdrawal takes on the recovering addict.

The most common physical symptoms of heroin withdrawal are:

  • Excessive sweating
  • Sneezing
  • Chills and goosebumps
  • Loss of appetite
  • Restless legs
  • Insomnia
  • The desire to use again
  • Nausea
  • Vomiting
  • Diarrhea
  • Aching bones and joints
  • Yawning
  • Itching
  • Leaking of fluids from eyes

The physical symptoms of heroin withdrawal will begin mildly between 6 and 12 hours after a heroin user’s last dose.  Early on, only one or a couple of these symptoms will manifest. Excessive sweating, chills, and desire to use again are all good indicators of the earliest stages of heroin withdrawal.  As the heroin user gets further from their last dose, their symptoms will continue to intensify. As the symptoms of heroin withdrawal intensify, recovering addicts will often experience a variety of these symptoms to different degrees.  

Many recovering addicts describe rapid fluctuations in certain symptoms, such as restless legs or fluid leakage, that then subside as other symptoms begin to intensify.  Many addicts and their loved ones wonder, “How long do the symptoms of heroin withdrawal last?” The truth is, it varies for everyone. Typically, most physical symptoms of heroin withdrawal peak in 5-7 days, and can last up to 2 weeks in acute cases.

One important thing to note about the physical symptoms of heroin withdrawal is the broad pattern of fluid loss.  The flu-like symptoms of heroin withdrawal carry with them one of the most significant risks associated with the seasonal flu; dehydration.  Dehydration places strain on all of the body’s systems, yet can also be easily ignored when a recovering heroin addict is under the influence of fully manifested withdrawal symptoms.  Recovering heroin addicts are extremely unlikely to be properly hydrated prior to entering withdrawal. This can further exacerbate the dehydration that is already almost certain to accompany full-blown withdrawal.  


Furthermore, recovering addicts are unlikely to properly hydrate throughout the withdrawal process, whether it be from not realizing the level of their dehydration to not being able to physically keep fluids down from excessive vomiting and diarrhea.  For recovering addicts undergoing heroin withdrawal, it is critically important to monitor their fluid levels and maintain adequate hydration. This can be extremely difficult, particularly if one is undergoing withdrawal “cold-turkey”, or without the assistance of qualified medical professionals.  Doing so further raises the risk of developing potentially serious health conditions as a result of withdrawal.

Mental and Emotional Withdrawal Symptoms

Although the physical symptoms of heroin withdrawal are those that are most commonly portrayed in popular media, they are far from the only effects that a recovering addict will experience during the withdrawal process.  Heroin withdrawal not only produces a profound effect on the body but also on the mental and emotional state of the recovering addict.

In many cases, the emotional and cognitive toll that withdrawal takes can be more difficult to navigate and last longer than the physical symptoms of heroin withdrawal.  As such, it is important for addicts contemplating the recovery process to be aware of the possible effects of heroin withdrawal on their emotional state. This is doubly true for the families and loved ones of addicts so that they might gain some insight into the challenges that the addict in their life is facing.  

During heroin withdrawal, the addict will begin to re-experience a broad range of emotions that they may not have felt for some time.  Frequent and long-term heroin use results in the suppression of the normal scope of human emotions, distilling these down into the basic need of maintaining an addiction.  Heroin’s ability to numb and sedate users further compounds this effect, resulting in far fewer emotions being felt, and less intensity when they are felt.

Withdrawal pulls back the veil that heroin places on the human emotional experience, leaving recovering addicts to navigate, sort through, and deal with their emotions in a new way.  While this is ultimately a positive and beneficial experience, it can also be extremely difficult. Many recovering heroin addicts have expressed frustration and difficulty with the length of time that it can take to experience and manage their emotions in a healthy way.

During the heroin withdrawal process, many of the emotions that were suppressed through regular heroin use manifest with startling intensity.  Increased anxiety, boredom, and sadness are all extremely commonplace. In many cases, these are emotions that are natural to feel when coming out of a heroin addiction, and represent the body’s efforts to readjust and attain a level of emotional equilibrium.

In some cases, however, the intense emotional spectrum and fluctuations felt and experienced during the withdrawal process may indicate an underlying mental health issue.  There is a high rate of comorbidity, or the existence of two simultaneous conditions, between heroin addiction and mental health issues. Heroin addicts often have one or more underlying mental health conditions.  These mental health conditions are frequently undiagnosed, leaving the addict unaware that they have an underlying mental health condition or unable to get the necessary treatment for it.

Minimizing the Impact of Withdrawal

Experiencing some effects from heroin withdrawal is inevitable.  Withdrawal is the process through which the body experiences a lack of a substance that it has become dependent on, then reaches a level of equilibrium and balance without that substance.  Heroin withdrawal is not an easy process, and it is one that every heroin addict must navigate.

However, there are ways to minimize the impact of withdrawal, reducing the felt effects and easing the transition from detox to recovery.  The most effective way to do this is to undergo heroin withdrawal under medical supervision and as part of a heroin addiction treatment plan.

Although undergoing heroin withdrawal without medical supervision is possible, it is not recommended.  The heroin withdrawal process places an enormous amount of strain on the human body, and many recovering addicts are already weakened as a result of their addiction.  They may enter withdrawal and detox dehydrated and with a compromised immune system. Dehydration can quickly become acute as a result of common withdrawal symptoms and can lead to life-threatening complications.  

Other health complications, like a compromised immune system, can quickly lead to more serious health outcomes.  It is also common for recovering addicts to have underlying medical health conditions whose effects were suppressed by heroin.  Recovering addicts may have persistent inflammation or infection whose signs were suppressed or minimized by the felt effects of a heroin high.  The existence of underlying medical conditions that have gone undiagnosed for an extended period of time is one of the most dangerous aspects of heroin withdrawal.

Without a comprehensive diagnosis by a medical professional, areas of high risk for the recovering addict can be missed or remain unknown.  This makes heroin withdrawal particularly dangerous when conducted alone. However, there are other practical reasons a heroin addict or their families should consider undergoing a medically managed withdrawal process.  

First, medically managed withdrawal not only means that the recovering addict will be monitored for any health complications, but it also means that physicians can intervene to help reduce the felt effects of withdrawal.  In many cases, recovering addicts may be given Methadone or Suboxone, two drugs that are used extensively to help wean heroin addicts off of heroin. Second, medically managed withdrawal is part of a more broad treatment plan and is done in an inpatient treatment facility.  This provides an important safety net for the recovering addict, which will often experience profound urges to begin using heroin again. For these reasons, medically managed withdrawal is much safer for the recovering addict.

Because it is far less uncomfortable and far safer, it is also much more effective, giving users the best chances of a successful and long-term recovery.  Families of recovering addicts, or recovering addicts themselves, are encouraged to get an assessment at a treatment facility that specializes in dual-diagnosis treatment.  This will allow medical professionals to treat heroin dependence and addiction alongside any underlying mental health conditions that may have been undiagnosed in the past.

In order to give you or your loved one the best chance on the journey to lifelong sobriety, be sure to consult with a qualified medical professional first to determine the best treatment pathway and strategy for you. There are many signs you are addicted to heroin. If you or a loved one is suffering, just know we are here to help you.